Sobriety Wod ! Sobriety WoD First Timers Question Title * 1. Welcome to Sobriety WoD! What's your name? First Last Question Title * 2. What is your email address? Question Title * 3. What is your ZIP code? Question Title * 4. Birthday? Date / Time Date Question Title * 5. What is your gender? Male Female Question Title * 6. How did you hear about Sobriety WoD? From a friend At the gym Facebook Instagram At a meeting Other (please specify) Question Title * 7. What is your sobriety date if applicable? Date / Time Date Question Title * 8. Are you involved in any other recovery specific programs? Yes, a 12 Step based program Yes, a non 12 Step based program No, not right now Other (please specify) Question Title * 9. If you had to pick one, what addiction are you primarily recovering from? Opiates (pill form) Opiates (Intravenous) Benzos Alcohol Cocaine Methamphetamines Prescription Amphetamines Freebase Cocaine / Crack Sugar/Food People/Relationships Not Applicable Other (please specify) All Done!